Provider Demographics
NPI:1487791497
Name:RACKOW, ERIC CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CHARLES
Last Name:RACKOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7528
Mailing Address - Country:US
Mailing Address - Phone:914-725-8152
Mailing Address - Fax:914-725-7175
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:NYU MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-2606
Practice Address - Fax:212-263-6553
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117169207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine